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Individual
BRENDEN J DAVIS
Active
Individual
BRENDEN J DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MPH
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60103956
WA
1223G0001X
General Practice Dentistry
DE60103956
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0255549
LABOR & INDUSTRIES
WA
05
—
5060215
—
WA
Enumeration date
08/17/2009
Last updated
08/04/2022
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